Equity in maternal health care service utilization: a systematic review for developing countries

Int J Public Health. 2015 Nov;60(7):815-25. doi: 10.1007/s00038-015-0711-x. Epub 2015 Aug 23.


Objectives: The objective was to explore progress of equity in the utilization of maternal health care services in developing countries since maternal care is a crucial factor in reducing maternal mortality, which is targeted by the Millennium Development Goal 5.

Methods: A systematic review of quantitative studies was done. PubMed Central, Web of Science, and Science Direct databases were searched for peer-reviewed and English-language articles published between 2005 and 2015.

Results: Thirty-six articles were included in the review. The results reveal the lack of equity in the utilization of maternal health care in developing countries. Thirty-three out of 36 studies found evidence supporting severe inequities while three studies found evidence of equity or at least improvement in terms of equity.

Conclusions: Most of the literature devoted to utilization of maternal health care generally provides information on the level of maternal care used and ignore the equity problem. Research in this area should focus not only on the level of maternal care used but also on the most disadvantaged segments of the population in terms of utilization of maternal care in order to reach the set targets.

Keywords: Developing countries; Equity; Health care utilization; Maternal care; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Developing Countries
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Maternal Health Services / statistics & numerical data*
  • Patient Acceptance of Health Care
  • Poverty
  • Pregnancy
  • Socioeconomic Factors